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Patient education and informed consent in head and neck surgery
Yvonne Chan1, Jonathan C Irish, Stephen J Wood
1Department of Otolaryngology, Wharton Head and Neck Centre, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
Objective:
To examine the effects of an educational intervention, in the form of printed material, on patient knowledge and recall of possible risks from parotidectomy or thyroidectomy.
Design:
Prospective, randomized, controlled study conducted during a 9-month period.
Setting:
Head and neck surgery clinic of an academic tertiary care hospital.
Patients:
One hundred twenty-five consecutive patients older than 16 years who were undergoing thyroidectomy or parotidectomy at the head and neck surgery clinic were recruited. Four patients were excluded from analysis because their follow-up interview was not within the required limits.
Intervention:
At the preoperative visit during the routine consent process, both groups received a verbally delivered checklist of risks specific for the surgery to be performed. The intervention group was also given a pamphlet with written information accompanied by illustrations.
Main Outcome Measures:
The effectiveness of the educational intervention was determined by comparing the average rate of risk recall between the intervention and control groups. The effects of age, sex, level of education, and time between the consent and recall interviews on recall rate were also assessed.
Results:
The overall risk recall rate for both procedures was 39.1%. The recall rate of the intervention group was 50.3% compared with 29.5% for the control group (P<.001).
Conclusions:
The intervention consistently improved risk recall for all patients regardless of age, sex, and level of education. Patients' ability to recall potential risks was significantly increased by an educational intervention; all patients would benefit from this intervention.